Raxa - Patient Medical Timeline

In the era of "Data and Information", data became the key to save lives. With the rapid growth in Information & Communication Technology (ICT), the power of Technology has strongly impacted our lives.Storing complex medical data of people become easier, but not easy enough to access to this information and understand it without the right technology solution, which make limits to patients from actively managing their own healthcare.

The project is built on prior efforts to re-design a new and efficient approach of interacting with large amounts of complex medical data through a «Timeline». It describes visually the when, for whom, and what has been done to describe patient's health care situation.

Our project has been constructed around standard health system goals and users areas, putting beneficiaries in central focus. Instead of using common factors to regroup data such as area, Gender…; we conceptualize the medical records as a whole information in one timeline page to better organize patients’ important health information and keep track of their daily habits, medications, and diets.

We harness the inherent user’s experience of web application, to simplify the access to various information, thus Patient Medical TimeLine, Timeline-based view for patient record images .

The project builds on prior efforts to empower developers, it facilities organizing "Medical Data", consuming data from an EHR-System using API. In our project we used "Open EMR", which is a popular Health-enhanced EHR, that allows frontline health workers to access information from a patient's health record using a mobile device and to contribute information into the health record.

We deliver in this project two repositories:

- Medical Timeline Project

- OpenMRS API Starter : to help developer to get familiar with this "Open Source" EHR, and quickly build project based on it .We believe that innovations in this space should be viewed not as independent, disconnected strategies but as vehicles to overcome persistent health system constraints.

What is eHealth ?

The term “health system” includes all activities in which the primary purpose is to promote, restore, or maintain health. [1]

eHealth aims to make an integrable systems that should fit into existing health system functions and complement the health system goals of: health service provision; a well-performing health workforce; a functioning health information system; cost-effective use of medical products, vaccines, and technologies; and accountability and governance .[2]

Project Overview :

"Medical Timeline" Project is part of Raxa.io eHealth System .

Raxa.io is an open source software to rural hospitals in India that can’t afford commercial solutions, provided for FREE by an India-based health IT company .The organization believes that freely offering electronic medical records (EMR) to patients and care providers in remote as well as urban areas in India can significantly improve the quality of care. They aim to maximize EMR usage in India by making their product available across many platforms, especially mobile phones and devices.

With a sophisticated server-side facilities for data aggregation, sharing, and visualization. we use an API to get data. Once we get them, we visualize these data through a "Timeline", after organizing the different data element .

The project offers of 2 main functions :

1. Patient Medical TimeLine : It would be customized by Patients, Doctors or Caregivers to fit the specific needs of any Patient .

2. Timeline-based view for patient record images : To share medical images, simplify the way we look-up and explore patients' medical images .

Objectives :

Create a Medical TimeLine with a simple design that offers a great potential for effectively acquiring, storing, retrieving, and analyzing medical data and information;
Making the interaction between doctors , caregivers and patients easier and simpler.
Accessing , assembling and analyzing large amount of data at the point of care to make a proper medical decision-making.
Designing a new way to visualize and explore medical image collections through medical timeline .
Building a OpenMRS API Starter to help developer to build productive medical application using REST calls .

We aim to add and facilitate the scheduling of individuals to make them informed through active reminders of upcoming or due/overdue services .

Project Layout :

Index.html : The main page
/Doc : contains presentation slides about the project.
/JS : contains different Java Script files

FakedData.js ; contains model of medical data classifier .

OpenMRSRestCalls.js : REST call functions to retrieve data using OpenMRS API.

VisualizeDataElements.js : contains algorithms that visualize data gotten in a timeline.

/css : contains different CSS Files
/fancybox : JQuery Fancybox plugin
/fonts : contains fonts files.

Project Development :

In order to develop this project, we went through different steps :

MEDICAL DATA ELEMENTS:

Various approaches has been discussed about what are Medical UX best-practices, draw a comparison between the actual and the anticipated, ideal UIs. We discussed specific patient care needs and contexts and the best ways to avoid confusion caused by “fragmented displays” and “hidden information” problems.

The interface should reflect clinicians’ mental model of medical problem-solving during patient encounters, the end-user should feel better whenever he uses the application.

In our case, we are consuming data from “OpenMRS” EHR System using REST call. But for those who are working on medical application ; We suggest this model

1.BASIC INFORMATION

Name Birthday Address

Gender | Marital Status | Smoking Status

2.REMINDER Block :

To remind the patient to take his medications / test’s dates / Visiting doctor / his (like : It’s recommended to visit doctor ).

3.History of Present Illness TimeLine :

3.1 # Observations :

Observation:
Status:
Date:
Notes :

3.2 # Allergies

Allergy Name:
Reaction:
Diagnosed : Yes / No
Note:

3.3 # Procedures (eg: Taking Labs’ tests , Doing a Surgery. )

Procedure:
Provider:
Location:
Date:

4. MEDICATION Timeline

Date:
Type:
Name of Medication:
Instructions: 2 pills a day
Frequency / Dose Quantity (value / unit): 1 / tablet
Rate Quantity (value / unit): 2 / day
Note : Reason why I take this medication

5. IMMUNIZATIONS Timeline :

#Block : Upcoming Immunizations

Date:
Immunization Name:
Type:
Dose Quantity (value / unit)
Notes / Instructions:

6.Care Plan Timeline :

6.1 #Activities (eg: Visiting Docotr , Doing Therapy ; Walking : Some of patients needs to do that ) .

Planned Activity Name:
Planned Date:
FREQUENCY
Instructions:
ADHERENCE : How often you practice this

6.2 # Encounters

Encounter:
Provider:
Location:
Date:

6.3 # Visits

Encounter:
Provider:
Location:
Date:

7. Vitals Timeline:

BLOOD PRESSURE | BODY TEMPERATURE | BODY WEIGHT | BODY MASS INDEX

8. Lab Results Timeline:

Test: Cholesterol / Blood Glucose /Lipid Panel /Triglyceride/LDL/HDL
Date :
Document : #Link

Status : Good / Normal / Low

9.Medical Images Timeline:

Name :
Date :
Provider :
IMAGES :

Sketching Up the Timeline :

We worked to make the user experience meet the exact needs of the patient, without any fuss or bother, we developed a timeline to make the information access faster and visualizing different medical data easier.

We preferred to make “One Side” timeline to make the UI scalable in the both browser or on Smart Devices .

[IMAGE 1]: Sketching the UI on Paper

Building Openmrs REST call :

This part demonstrates how to interact with the OpenMRS REST API using JQuery REST calls via the OAuth2 library.

At the beginning, we built a simple application that get information through JQUERY REST API call with basic authentication.

Then we started getting different data elements by consuming data from Raxa Server

OPENMRS_REST_HOST = 'http://raxaemr.elasticbeanstalk.com';

We consume data by using REST calls, for example : if we want fetching observation resource

var REST_OBS = '/ws/rest/v1/obs?patient=65ea509b-1f90-461f-9879-62004cc8a3b6';

More information about the consumed Data : https://raxaemr.atlassian.net/wiki/display/RAXAJSS/Raxacore+REST+resources

Once we get data using OpenMRS Rest call, we built JavaScript Script to visualize these data after classifying it in a timeline .

Mentors :

Acknowledgements :

This project is developed for Raxa , as part of Google Summer of Code Program.